Ambetter SilverSummit

Ambetter Balanced Care 31 + Vision + Adult Dental

Prescription Drug Information

Inpatient Coverage

Emergency and Urgent Care

Links

Plan Overview

Medical Deductible	Individual: $5,450 Family: $10,900 Per Person: $5,450
Prescription Drug Deductible	Individual: Included in Medical Family: Included in Medical Per Person: Included in Medical
Medical Out-of-Pocket Maximum	Individual: $6,450 Family: $12,900 Per Person: $6,450
Drug Out-of-Pocket Maximum	Individual: Included in Medical Family: Included in Medical Per Person: Included in Medical

Office Visit

Primary Doctor	Standard: 10% Coinsurance after deductible
Specialist	Standard: 10% Coinsurance after deductible

Prescription Drug Information

Preferred Brand Drugs	Standard: 10% Coinsurance after deductible
Non Preferred Brand Drugs	Standard: 50% Coinsurance after deductible
Generic Drugs	Standard: 10% Coinsurance after deductible
Specialty Drugs	Standard: 50% Coinsurance after deductible

Inpatient Coverage

Hospital Services	Standard: 10% Coinsurance after deductible
Inpatient Services	Standard: 10% Coinsurance after deductible

Emergency and Urgent Care

Emergency Room

Standard: 10% Coinsurance after deductible

Related Articles

You may be interested in these relevant articles from across the HealthMarkets.com network.

What’s the difference between an M.D. vs a D.O.?

If you check your area for the closest doctor, you may find that some…Read More

Read More

What you need to know about accelerated life insurance benefits

Life insurance might seem straightforward: You buy a policy, pay for it annually or…Read More

Read More

Find an In-Network Provider: 5 Tips To Get Care And Save Money

Looking for a health care provider? There’s something you need to do before you…Read More

Read More